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Babiloni C, Gentilini Cacciola E, Tucci F, Vassalini P, Chilovi A, Jakhar D, Musat AM, Salvatore M, Soricelli A, Stocchi F, Vacca L, Ferri R, Catania V, Mastroianni C, D'Ettorre G, Noce G. Resting-state EEG rhythms are abnormal in post COVID-19 patients with brain fog without cognitive and affective disorders. Clin Neurophysiol 2024; 161:159-172. [PMID: 38492271 DOI: 10.1016/j.clinph.2024.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 02/13/2024] [Accepted: 02/29/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVES Several persons experiencing post-covid-19 (post-COVID) with "brain fog" (e.g., fatigue, cognitive and psychiatric disorders, etc.) show abnormal resting-state electroencephalographic (rsEEG) rhythms reflecting a vigilance dysfunction. Here, we tested the hypothesis that in those post-COVID persons, abnormal rsEEG rhythms may occur even when cognitive and psychiatric disorders are absent. METHODS The experiments were performed on post-COVID participants about one year after hospitalization for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Inclusion criteria included a "brain fog" claim, no pre-infection, and actual organic chronic disease. Matched controls (no COVID) were also enrolled. All participants underwent clinical/neuropsychological assessment (including fatigue assessment) and rsEEG recordings. The eLORETA freeware estimated regional rsEEG cortical sources at individual delta (<4 Hz), theta (4-7 Hz), and alpha (8-13 Hz) bands. Beta (14-30 Hz) and gamma (30-40 Hz) bands were pre-fixed. RESULTS More than 90% of all post-COVID participants showed no cognitive or psychiatric disorders, and 75% showed ≥ 2 fatigue symptoms. The post-COVID group globally presented lower posterior rsEEG alpha source activities than the Control group. This effect was more significant in the long COVID-19 patients with ≥ 2 fatigue symptoms. CONCLUSIONS In post-COVID patients with no chronic diseases and cognitive/psychiatric disorders, "brain fog" can be associated with abnormal posterior rsEEG alpha rhythms and subjective fatigue. SIGNIFICANCE These abnormalities may be related to vigilance and allostatic dysfunctions.
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Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology "Erspamer," Sapienza University of Rome, Rome, Italy; Hospital San Raffaele Cassino, Cassino, FR, Italy.
| | - Elio Gentilini Cacciola
- Department of Public Health and Infectious Diseases, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Federico Tucci
- Department of Physiology and Pharmacology "Erspamer," Sapienza University of Rome, Rome, Italy
| | - Paolo Vassalini
- Department of Public Health and Infectious Diseases, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Agnese Chilovi
- Department of Public Health and Infectious Diseases, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Dharmendra Jakhar
- Department of Physiology and Pharmacology "Erspamer," Sapienza University of Rome, Rome, Italy
| | - Andreea Maria Musat
- Department of Physiology and Pharmacology "Erspamer," Sapienza University of Rome, Rome, Italy
| | | | - Andrea Soricelli
- IRCCS Synlab SDN, Naples, Italy; Department of Medical, Movement and Wellbeing Sciences, University of Naples Parthenope, Naples, Italy
| | - Fabrizio Stocchi
- IRCCS San Raffaele Rome, Rome, Italy; Telematic University San Raffaele, Rome, Italy
| | | | | | | | - Claudio Mastroianni
- Department of Public Health and Infectious Diseases, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Gabriella D'Ettorre
- Department of Public Health and Infectious Diseases, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
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Kowal M, Morgiel E, Winiarski S, Dymarek R, Bajer W, Madej M, Sebastian A, Madziarski M, Wedel N, Proc K, Madziarska K, Wiland P, Paprocka-Borowicz M. Ebbing Strength, Fading Power: Unveiling the Impact of Persistent Fatigue on Muscle Performance in COVID-19 Survivors. SENSORS (BASEL, SWITZERLAND) 2024; 24:1250. [PMID: 38400407 PMCID: PMC10892381 DOI: 10.3390/s24041250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/05/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024]
Abstract
The total number of confirmed cases of COVID-19 caused by SARS-CoV-2 virus infection is over 621 million. Post-COVID-19 syndrome, also known as long COVID or long-haul COVID, refers to a persistent condition where individuals experience symptoms and health issues after the acute phase of COVID-19. The aim of this study was to assess the strength and fatigue of skeletal muscles in people recovered from COVID-19. A total of 94 individuals took part in this cross-sectional study, with 45 participants (referred to as the Post-COVID Cohort, PCC) and 49 healthy age-matched volunteers (Healthy Control Cohort, HCC). This research article uses the direct dynamometry method to provide a detailed analysis of post-COVID survivors' strength and power characteristics. The Biodex System 4 Pro was utilized to evaluate muscle strength characteristics during the fatigue test. The fatigue work in extensors and flexors was significantly higher in the PCC. The PCC also showed significantly less power in both extensors and flexors compared to the HCC. In conclusion, this study provides compelling evidence of the impact of post-COVID-19 fatigue on muscle performance, highlighting the importance of considering these effects in the rehabilitation and care of individuals recovering from the virus. PCC achieved lower muscle strength values than HCC.
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Affiliation(s)
- Mateusz Kowal
- Department of Physiotherapy, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.K.); (W.B.); (M.P.-B.)
| | - Ewa Morgiel
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland; (E.M.); (M.M.); (A.S.); (P.W.)
| | - Sławomir Winiarski
- Biomechanics Department, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland;
| | - Robert Dymarek
- Department of Physiotherapy, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.K.); (W.B.); (M.P.-B.)
| | - Weronika Bajer
- Department of Physiotherapy, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.K.); (W.B.); (M.P.-B.)
| | - Marta Madej
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland; (E.M.); (M.M.); (A.S.); (P.W.)
| | - Agata Sebastian
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland; (E.M.); (M.M.); (A.S.); (P.W.)
| | - Marcin Madziarski
- Department of Rheumatology and Internal Medicine, University Teaching Hospital, 50-556 Wroclaw, Poland; (M.M.); (K.P.)
| | - Nicole Wedel
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Krzysztof Proc
- Department of Rheumatology and Internal Medicine, University Teaching Hospital, 50-556 Wroclaw, Poland; (M.M.); (K.P.)
| | - Katarzyna Madziarska
- Clinical Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Piotr Wiland
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland; (E.M.); (M.M.); (A.S.); (P.W.)
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Jang M, Choi D, Choi J, Kwon HJ. Clinical Features and Risk Factors of Post-COVID-19 Condition in Korea. J Prev Med Public Health 2023; 56:431-439. [PMID: 37735829 PMCID: PMC10579640 DOI: 10.3961/jpmph.23.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/11/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVES Numerous studies have explored the causes and spread of outbreaks, yet there is a lack of research on post-coronavirus disease 2019 condition (PCC) in Korea. The goal of this study was to identify the various types of PCC and associated factors in discharged patients and to provide directions for the ongoing health management of confirmed patients. METHODS A telephone survey was conducted among 680 coronavirus disease 2019 (COVID-19) patients diagnosed between July 7, 2021 and August 26, 2021, in Dangjin, Chungnam, Korea. A descriptive analysis of characteristics, univariate analysis, and regression were performed using data from basic epidemiological surveys conducted at the time of diagnosis and post-discharge questionnaires. RESULTS Of the 585 patients who responded, 159 (27.2%) developed PCC. Of the 211 patients with no initial symptoms, 27 (12.8%) developed PCC, versus 132 (35.3%) of the 374 patients with initial symptoms. Among the initial symptoms, fever or chills, cough or sputum, loss of smell, and sore throat were associated with PCC. Compared to patients with less than 10 days of hospitalization, those with a hospitalization period of 21 days to 30 days (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.0 to 5.2) and 31 days or more (OR, 5.8; 95% CI, 1.9 to 18.1) had a higher risk of PCC. CONCLUSIONS More than a quarter of COVID-19 patients, including those who had no initial symptoms, experienced PCC in Korea. People with the initial symptoms of fever, chills, and respiratory symptoms and those who had prolonged hospital stays had a high risk of PCC.
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Affiliation(s)
- Myungwon Jang
- Epidemic Intelligence Officer, Dangjin City Public Health Center, Dangjin, Korea
| | - Dongkwon Choi
- Chungnam Center for Infectious Diseases Control and Prevention, Hongseong, Korea
| | - Jonghyuk Choi
- Chungnam Center for Infectious Diseases Control and Prevention, Hongseong, Korea
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Ho-Jang Kwon
- Chungnam Center for Infectious Diseases Control and Prevention, Hongseong, Korea
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
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Furlanis G, Buoite Stella A, Biaduzzini F, Bellavita G, Frezza NA, Olivo S, Menichelli A, Lunardelli A, Ajčević M, Manganotti P. Cognitive deficit in post-acute COVID-19: an opportunity for EEG evaluation? Neurol Sci 2023; 44:1491-1498. [PMID: 36749529 PMCID: PMC9902820 DOI: 10.1007/s10072-023-06615-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 01/10/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND PURPOSE Among the most common post-COVID symptoms, many patients experienced subjective cognitive deficit, commonly named "brain fog," that might be present also in those individuals without severe acute COVID-19 respiratory involvement. Some studies have investigated some of the mechanisms that might be associated with the brain fog with objective techniques including transcranial magnetic stimulation and neuroimaging. METHODS The aim of this study was to investigate the presence of electroencephalographic (EEG) alterations in people with post-COVID self-reported cognitive deficit. RESULTS Out of the 90 patients attending the post-COVID neurology ambulatory service, twenty patients presenting brain fog at least 4 weeks after acute non-severe COVID-19 infection, and without previous history of epilepsy, were investigated with 19-channel EEG, Montreal Cognitive Assessment (MoCA), and magnetic resonance imaging (MRI). EEG was found altered in 65% of the sample, among which 69% presented a slowing activity and 31% were characterized by epileptic discharges principally in the frontal areas. None of the patients showed DWI MRI lesions. CONCLUSIONS These findings highlight the usefulness of EEG analysis to objectively describe possible neurophysiological abnormalities in post-COVID patients presenting subjective cognitive deficit.
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Affiliation(s)
- Giovanni Furlanis
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste - ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy
| | - Alex Buoite Stella
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste - ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy
| | - Francesco Biaduzzini
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste - ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy
| | - Giulia Bellavita
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste - ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy
| | - Nicolò Arjuna Frezza
- School of Medicine and Surgery, Department of Medicine, Surgery and Health Sciences, Trieste University Hospital-ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy
| | - Sasha Olivo
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste - ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy
| | - Alina Menichelli
- Rehabilitation Unit, Department of Medicine, Surgery and Health Sciences, Maggiore City Hospital, Trieste, Italy
| | - Alberta Lunardelli
- Rehabilitation Unit, Department of Medicine, Surgery and Health Sciences, Maggiore City Hospital, Trieste, Italy
| | - Miloš Ajčević
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste - ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy ,Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Paolo Manganotti
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste - ASUGI, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy.
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Krasnienkov DS, Gorodna OV, Kaminska TM, Podolskiy VV, Podolskiy VV, Nechyporenko MV, Antypkin YG, Livshits LA. Analysis of Relative Average Length of Telomeres in Leukocytes of Women with COVID-19. CYTOL GENET+ 2022; 56:526-529. [PMCID: PMC9702697 DOI: 10.3103/s0095452722060056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/13/2022] [Accepted: 11/08/2022] [Indexed: 11/29/2022]
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The potential role of ischaemia-reperfusion injury in chronic, relapsing diseases such as rheumatoid arthritis, Long COVID, and ME/CFS: evidence, mechanisms, and therapeutic implications. Biochem J 2022; 479:1653-1708. [PMID: 36043493 PMCID: PMC9484810 DOI: 10.1042/bcj20220154] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 02/07/2023]
Abstract
Ischaemia–reperfusion (I–R) injury, initiated via bursts of reactive oxygen species produced during the reoxygenation phase following hypoxia, is well known in a variety of acute circumstances. We argue here that I–R injury also underpins elements of the pathology of a variety of chronic, inflammatory diseases, including rheumatoid arthritis, ME/CFS and, our chief focus and most proximally, Long COVID. Ischaemia may be initiated via fibrin amyloid microclot blockage of capillaries, for instance as exercise is started; reperfusion is a necessary corollary when it finishes. We rehearse the mechanistic evidence for these occurrences here, in terms of their manifestation as oxidative stress, hyperinflammation, mast cell activation, the production of marker metabolites and related activities. Such microclot-based phenomena can explain both the breathlessness/fatigue and the post-exertional malaise that may be observed in these conditions, as well as many other observables. The recognition of these processes implies, mechanistically, that therapeutic benefit is potentially to be had from antioxidants, from anti-inflammatories, from iron chelators, and via suitable, safe fibrinolytics, and/or anti-clotting agents. We review the considerable existing evidence that is consistent with this, and with the biochemical mechanisms involved.
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Barbagelata L, Masson W, Iglesias D, Lillo E, Migone JF, Orazi ML, Maritano Furcada J. Cardiopulmonary Exercise Testing in Patients with Post-COVID-19 Syndrome. MEDICINA CLINICA (ENGLISH ED.) 2022; 159:6-11. [PMID: 35814791 PMCID: PMC9254647 DOI: 10.1016/j.medcle.2021.07.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 07/20/2021] [Indexed: 01/31/2023]
Abstract
Background and aim Several reports have shown the persistence of long term symptoms after the initial COVID-19 infection (post-COVID-19 syndrome). The objective of this study was to analyze the characteristics of cardiopulmonary exercise testing (CPET) performed in patients with a history of COVID-19, comparing subjects according to the presence of post-COVID-19 syndrome. Methods A cross-sectional study was performed. Consecutive patients >18 years with history of SARS-CoV-2 infection confirmed by polymerase chain reaction test and a CPET performed between 45 and 120 days after the viral episode were included. The association between variables related to CPET and post-COVID-19 syndrome was assessed using univariate and multivariate analysis. Results A total of 200 patients (mean age 48.8 ± 14.3 years, 51% men) were included. Patients with post-COVID-19 syndrome showed significantly lower main peak VO2 (25.8 ± 8.1 mL/min/kg vs. 28.8 ± 9.6 mL/min/kg, p = 0.017) as compared to asymptomatic subjects. Moreover, patients with post-COVID-19 syndrome developed symptoms more frequently during CPET (52.7% vs. 13.7%, p < 0.001) and were less likely to reach the anaerobic threshold (50.9% vs. 72.7%, p = 0.002) when compared to asymptomatic subjects. These findings were not modified when adjusting for confounders. Conclusion Our data suggest that post-COVID-19 syndrome was associated with less peak VO2, a lower probability of achieving the anaerobic threshold and a higher probability of presenting symptoms during the CPET. Future studies are needed to determine if these abnormalities during CPET would have prognostic value.
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Affiliation(s)
- Leandro Barbagelata
- Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina,Corresponding author
| | - Walter Masson
- Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
| | - Diego Iglesias
- Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
| | - Ezequiel Lillo
- Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
| | - Juan Francisco Migone
- Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
| | - Maria Laura Orazi
- Pulmonology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
| | - Joaquin Maritano Furcada
- Pulmonology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
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Fairman KA. Pandemics, Policy, and the Power of Paradigm: Will COVID-19 Lead to a New Scientific Revolution? Ann Epidemiol 2022; 69:17-23. [PMID: 35231588 PMCID: PMC8882036 DOI: 10.1016/j.annepidem.2022.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 12/30/2021] [Accepted: 02/22/2022] [Indexed: 12/02/2022]
Abstract
Critical historical analysis of the 19th-century cholera and 21st-century coronavirus-19 (COVID-19) pandemics suggests that in conflicts over pandemic-mitigation policies, the professional backgrounds of principal opponents reveal dominant and minority scientific paradigms, presaging possible epistemological shifts. Epistemic conflict over cholera helped spur biomedical expertise as the dominant paradigm for U.S. public health science and policy beginning in the 20th century. This paradigm was reflected in federal government reliance on infectious disease physicians as the primary scientific decision makers in the COVID-19 pandemic. Similarly, epistemic conflict over challenges to behavioral and social well-being in 2020 may highlight discordance between the dominant biomedical paradigm used in making federal policy and the inherently holistic impact of that policy on population health, suggesting need for a new paradigm of multidisciplinary scientific engagement. Because population-wide public health initiatives affect many aspects of health—physiological, psychological, behavioral, and social—that are best measured and interpreted by experts in these respective fields, multidisciplinary scientific engagement would facilitate optimal, holistic evaluation of policy benefits and harms. This multidisciplinary approach, analogous to that currently recommended in medical management of chronic disease, would advance epidemiological research to inform evidence-based policy for public health crises in which U.S. population-wide interventions are contemplated.
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Diaz JV, Herridge M, Bertagnolio S, Davis HE, Dua T, Kaushic C, Marshall JC, del Rosario Pérez M, Strub-Wourgaft N, Soriano JB. Towards a universal understanding of post COVID-19 condition. Bull World Health Organ 2021; 99:901-903. [PMID: 34866686 PMCID: PMC8640686 DOI: 10.2471/blt.21.286249] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/07/2021] [Accepted: 06/24/2021] [Indexed: 12/28/2022] Open
Affiliation(s)
- Janet V Diaz
- Clinical Management Team, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Margaret Herridge
- Department of Medicine, Interdepartmental Division of Critical Care, University of Toronto, Toronto, Canada
| | - Silvia Bertagnolio
- Department of Control, Surveillance and Prevention of Antimicrobial Resistance, World Health Organization, Geneva, Switzerland
| | - Hannah E Davis
- Patient-Led Research Collaborative, United States of America
| | - Tarun Dua
- Brain Health Unit, World Health Organization, Geneva, Switzerland
| | - Charu Kaushic
- CIHR Institute of Infection and Immunity, McMaster University, Hamilton, Canada
| | - John C Marshall
- Departments of Surgery and Critical Care Medicine, St Michael's Hospital, Toronto, Canada
| | - Maria del Rosario Pérez
- Clinical Management Team, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | | | - Joan B Soriano
- Clinical Management Team, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
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Deligiorgi MV, Siasos G, Vakkas L, Trafalis DT. Charting the Unknown Association of COVID-19 with Thyroid Cancer, Focusing on Differentiated Thyroid Cancer: A Call for Caution. Cancers (Basel) 2021; 13:5785. [PMID: 34830939 PMCID: PMC8616091 DOI: 10.3390/cancers13225785] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/10/2021] [Accepted: 11/16/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Conceived of as the "silver lining" of the dark cloud of the coronavirus disease 2019 (COVID-19) pandemic, lessons taught by this catastrophe should be leveraged by medical authorities and policy makers to optimize health care globally. A major lesson is that resilient health systems should absorb sudden shocks incited by overwhelming health emergencies without compromising the continuum of care of chronic diseases, especially of cancer. METHODS The present review dissects the association between COVID-19 and thyroid cancer (TC), especially with differentiated TC (DTC), focusing on available data, knowledge gaps, current challenges, and future perspectives. RESULTS Obesity has been incriminated in terms of both COVID-19 severity and a rising incidence of TC, especially of DTC. The current conceptualization of the pathophysiological landscape of COVID-19-(D)TC association implicates an interplay between obesity, inflammation, immunity, and oxidative stress. Whether COVID-19 could aggravate the health burden posed by (D)TC or vice versa has yet to be clarified. Improved understanding and harnessing of the pathophysiological landscape of the COVID-19-(D)TC association will empower a mechanism-guided, safe, evidence-based, and risk-stratified management of (D)TC in the COVID-19 era and beyond. CONCLUSION A multidisciplinary patient-centered decision-making will ensure high-quality (D)TC care for patients, with or without COVID-19.
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Affiliation(s)
- Maria V. Deligiorgi
- Clinical Pharmacology Unit–Department of Pharmacology, Faculty of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias St., 11527 Athens, Greece; (L.V.); (D.T.T.)
| | - Gerasimos Siasos
- First Department of Cardiology, Hippokration General Hospital of Athens, Faculty of Mediine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Lampros Vakkas
- Clinical Pharmacology Unit–Department of Pharmacology, Faculty of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias St., 11527 Athens, Greece; (L.V.); (D.T.T.)
| | - Dimitrios T. Trafalis
- Clinical Pharmacology Unit–Department of Pharmacology, Faculty of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias St., 11527 Athens, Greece; (L.V.); (D.T.T.)
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Asadi-Pooya AA, Akbari A, Emami A, Lotfi M, Rostamihosseinkhani M, Nemati H, Barzegar Z, Kabiri M, Zeraatpisheh Z, Farjoud-Kouhanjani M, Jafari A, Sasannia F, Ashrafi S, Nazeri M, Nasiri S, Shahisavandi M. Risk Factors Associated with Long COVID Syndrome: A Retrospective Study. IRANIAN JOURNAL OF MEDICAL SCIENCES 2021; 46:428-436. [PMID: 34840383 PMCID: PMC8611223 DOI: 10.30476/ijms.2021.92080.2326] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/30/2021] [Accepted: 09/29/2021] [Indexed: 12/22/2022]
Abstract
Background Recently, people have recognized the post-acute phase symptoms of the COVID-19. We investigated the long-term symptoms associated with COVID-19, (Long COVID Syndrome), and the risk factors associated with it. Methods This was a retrospective observational study. All the consecutive adult patients referred to the healthcare facilities anywhere in Fars province from 19 February 2020 until 20 November 2020 were included. All the patients had a confirmed COVID-19 diagnosis. In a phone call to the patients, at least three months after their discharge from the hospital, we obtained their current information. The IBM SPSS Statistics (version 25.0) was used. Pearson Chi square, Fisher's exact test, t test, and binary logistic regression analysis model were employed. A P value of less than 0.05 was considered to be significant. Results In total, 4,681 patients were studied, 2915 of whom (62.3%) reported symptoms. The most common symptoms of long COVID syndrome were fatigue, exercise intolerance, walking intolerance, muscle pain, and shortness of breath. Women were more likely to experience long-term COVID syndrome than men (Odds Ratio: 1,268; 95% Confidence Interval: 1,122-1,432; P=0.0001), which was significant. Presentation with respiratory problems at the onset of illness was also significantly associated with long COVID syndrome (Odds Ratio: 1.425; 95% Confidence Interval: 1.177-1.724; P=0.0001). A shorter length of hospital stay was inversely associated with long COVID syndrome (Odds Ratio: 0.953; 95% Confidence Interval: 0.941-0.965; P=0.0001). Conclusion Long COVID syndrome is a frequent and disabling condition and has significant associations with sex (female), respiratory symptoms at the onset, and the severity of the illness.
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Affiliation(s)
- Ali Akbar Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Neurology, Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ali Akbari
- Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Emami
- Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrzad Lotfi
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Hamid Nemati
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohreh Barzegar
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Kabiri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Zeraatpisheh
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Anahita Jafari
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fateme Sasannia
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shayan Ashrafi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoume Nazeri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Nasiri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mina Shahisavandi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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12
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Bateman L, Bested AC, Bonilla HF, Chheda BV, Chu L, Curtin JM, Dempsey TT, Dimmock ME, Dowell TG, Felsenstein D, Kaufman DL, Klimas NG, Komaroff AL, Lapp CW, Levine SM, Montoya JG, Natelson BH, Peterson DL, Podell RN, Rey IR, Ruhoy IS, Vera-Nunez MA, Yellman BP. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Essentials of Diagnosis and Management. Mayo Clin Proc 2021; 96:2861-2878. [PMID: 34454716 DOI: 10.1016/j.mayocp.2021.07.004] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/30/2021] [Accepted: 07/06/2021] [Indexed: 02/08/2023]
Abstract
Despite myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) affecting millions of people worldwide, many clinicians lack the knowledge to appropriately diagnose or manage ME/CFS. Unfortunately, clinical guidance has been scarce, obsolete, or potentially harmful. Consequently, up to 91% of patients in the United States remain undiagnosed, and those diagnosed often receive inappropriate treatment. These problems are of increasing importance because after acute COVID-19, a significant percentage of people remain ill for many months with an illness similar to ME/CFS. In 2015, the US National Academy of Medicine published new evidence-based clinical diagnostic criteria that have been adopted by the US Centers for Disease Control and Prevention. Furthermore, the United States and other governments as well as major health care organizations have recently withdrawn graded exercise and cognitive-behavioral therapy as the treatment of choice for patients with ME/CFS. Recently, 21 clinicians specializing in ME/CFS convened to discuss best clinical practices for adults affected by ME/CFS. This article summarizes their top recommendations for generalist and specialist health care providers based on recent scientific progress and decades of clinical experience. There are many steps that clinicians can take to improve the health, function, and quality of life of those with ME/CFS, including those in whom ME/CFS develops after COVID-19. Patients with a lingering illness that follows acute COVID-19 who do not fully meet criteria for ME/CFS may also benefit from these approaches.
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Affiliation(s)
| | - Alison C Bested
- Integrative Medicine, Dr Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL
| | - Hector F Bonilla
- Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Palo Alto, CA
| | | | - Lily Chu
- Independent Consultant, Burlingame, CA.
| | | | | | | | | | - Donna Felsenstein
- Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston
| | | | - Nancy G Klimas
- Institute for Neuro Immune Medicine, Dr Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL
| | | | | | | | - Jose G Montoya
- Dr Jack S. Remington Laboratory for Specialty Diagnostics, Palo Alto Medical Foundation Research Institute, Palo Alto, CA
| | - Benjamin H Natelson
- Pain & Fatigue Study Center, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | - Irma R Rey
- Institute for Neuro Immune Medicine, Dr Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL
| | - Ilene S Ruhoy
- Neurology, Chiari/EDS Center, Mount Sinai South Nassau, Oceanside, NY
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13
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Asadi-Pooya AA, Akbari A, Emami A, Lotfi M, Rostamihosseinkhani M, Nemati H, Barzegar Z, Kabiri M, Zeraatpisheh Z, Farjoud-Kouhanjani M, Jafari A, Sasannia F, Ashrafi S, Nazeri M, Nasiri S, Shahisavandi M. Long COVID syndrome-associated brain fog. J Med Virol 2021; 94:979-984. [PMID: 34672377 PMCID: PMC8662118 DOI: 10.1002/jmv.27404] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 01/03/2023]
Abstract
We investigated the frequency of brain fog in a large cohort of patients with documented coronavirus disease-2019 (COVID-19) who have survived the illness. We also scrutinized the potential risk factors associated with the development of brain fog. Adult patients (18-55 years of age), who were referred to the healthcare facilities anywhere in Fars province from February 19, 2020 to November 20, 2020 were included. All patients had a confirmed COVID-19 diagnosis. In a phone call, at least 3 months after their discharge from the hospital, we obtained their current information. A questionnaire was specifically designed for data collection. In total, 2696 patients had the inclusion criteria; 1680 (62.3%) people reported long COVID syndrome (LCS). LCS-associated brain fog was reported by 194 (7.2%) patients. Female sex (odds ratio [OR]: 1.4), respiratory problems at the onset (OR: 1.9), and intensive care unit (ICU) admission (OR: 1.7) were significantly associated with reporting chronic post-COVID "brain fog" by the patients. In this large population-based study, we report that chronic post-COVID "brain fog" has significant associations with sex (female), respiratory symptoms at the onset, and the severity of the illness (ICU admission).
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Affiliation(s)
- Ali A Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Neurology, Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ali Akbari
- Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Emami
- Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrzad Lotfi
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Hamid Nemati
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohreh Barzegar
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Kabiri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Zeraatpisheh
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Anahita Jafari
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fateme Sasannia
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shayan Ashrafi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoume Nazeri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Nasiri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mina Shahisavandi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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14
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The Post-Acute Phase of SARS-CoV-2 Infection in Two Macaque Species Is Associated with Signs of Ongoing Virus Replication and Pathology in Pulmonary and Extrapulmonary Tissues. Viruses 2021; 13:v13081673. [PMID: 34452537 PMCID: PMC8402919 DOI: 10.3390/v13081673] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/13/2021] [Accepted: 08/18/2021] [Indexed: 12/21/2022] Open
Abstract
The post-acute phase of SARS-CoV-2 infection was investigated in rhesus (Macaca mulatta) and cynomolgus macaques (Macaca fascicularis). During the acute phase of infection, SARS-CoV-2 was shed via the nose and throat, and viral RNA was occasionally detected in feces. This phase coincided with a transient change in systemic immune activation. Even after the alleged resolution of the infection, computed tomography (CT) and positron emission tomography (PET)-CT revealed pulmonary lesions and activated tracheobronchial lymph nodes in all animals. Post-mortem histological examination of the lung tissue revealed mostly marginal or resolving minimal lesions that were indicative of SARS-CoV-2 infection. Evidence for SARS-CoV-2-induced histopathology was also found in extrapulmonary tissue samples, such as conjunctiva, cervical, and mesenteric lymph nodes. However, 5–6 weeks after SARS-CoV-2 exposure, upon necropsy, viral RNA was still detectable in a wide range of tissue samples in 50% of the macaques and included amongst others the heart, the respiratory tract and surrounding lymph nodes, salivary gland, and conjunctiva. Subgenomic messenger RNA was detected in the lungs and tracheobronchial lymph nodes, indicative of ongoing virus replication during the post-acute phase. These results could be relevant for understanding the long-term consequences of COVID-19 in humans.
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15
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Barbagelata L, Masson W, Iglesias D, Lillo E, Migone JF, Orazi ML, Maritano Furcada J. Cardiopulmonary Exercise Testing in Patients with Post-COVID-19 Syndrome. Med Clin (Barc) 2021; 159:6-11. [PMID: 34417020 PMCID: PMC8318690 DOI: 10.1016/j.medcli.2021.07.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIM Several reports have shown the persistence of long term symptoms after the initial COVID-19 infection (post-COVID-19 syndrome). The objective of this study was to analyze the characteristics of cardiopulmonary exercise testing (CPET) performed in patients with a history of COVID-19, comparing subjects according to the presence of post-COVID-19 syndrome. METHODS A cross-sectional study was performed. Consecutive patients >18 years with history of SARS-CoV-2 infection confirmed by polymerase chain reaction test and a CPET performed between 45 and 120 days after the viral episode were included. The association between variables related to CPET and post-COVID-19 syndrome was assessed using univariate and multivariate analysis. RESULTS A total of 200 patients (mean age 48.8±14.3 years, 51% men) were included. Patients with post-COVID-19 syndrome showed significantly lower main peak VO2 (25.8±8.1mL/min/kg vs. 28.8±9.6mL/min/kg, p=0.017) as compared to asymptomatic subjects. Moreover, patients with post-COVID-19 syndrome developed symptoms more frequently during CPET (52.7% vs. 13.7%, p<0.001) and were less likely to reach the anaerobic threshold (50.9% vs. 72.7%, p=0.002) when compared to asymptomatic subjects. These findings were not modified when adjusting for confounders. CONCLUSION Our data suggest that post-COVID-19 syndrome was associated with less peak VO2, a lower probability of achieving the anaerobic threshold and a higher probability of presenting symptoms during the CPET. Future studies are needed to determine if these abnormalities during CPET would have prognostic value.
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Affiliation(s)
- Leandro Barbagelata
- Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina.
| | - Walter Masson
- Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
| | - Diego Iglesias
- Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
| | - Ezequiel Lillo
- Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
| | - Juan Francisco Migone
- Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
| | - Maria Laura Orazi
- Pulmonology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
| | - Joaquin Maritano Furcada
- Pulmonology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
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16
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Mongelli A, Barbi V, Gottardi Zamperla M, Atlante S, Forleo L, Nesta M, Massetti M, Pontecorvi A, Nanni S, Farsetti A, Catalano O, Bussotti M, Dalla Vecchia LA, Bachetti T, Martelli F, La Rovere MT, Gaetano C. Evidence for Biological Age Acceleration and Telomere Shortening in COVID-19 Survivors. Int J Mol Sci 2021; 22:ijms22116151. [PMID: 34200325 PMCID: PMC8201243 DOI: 10.3390/ijms22116151] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 12/18/2022] Open
Abstract
The SARS-CoV-2 infection determines the COVID-19 syndrome characterized, in the worst cases, by severe respiratory distress, pulmonary and cardiac fibrosis, inflammatory cytokine release, and immunosuppression. This condition has led to the death of about 2.15% of the total infected world population so far. Among survivors, the presence of the so-called persistent post-COVID-19 syndrome (PPCS) is a common finding. In COVID-19 survivors, PPCS presents one or more symptoms: fatigue, dyspnea, memory loss, sleep disorders, and difficulty concentrating. In this study, a cohort of 117 COVID-19 survivors (post-COVID-19) and 144 non-infected volunteers (COVID-19-free) was analyzed using pyrosequencing of defined CpG islands previously identified as suitable for biological age determination. The results show a consistent biological age increase in the post-COVID-19 population, determining a DeltaAge acceleration of 10.45 ± 7.29 years (+5.25 years above the range of normality) compared with 3.68 ± 8.17 years for the COVID-19-free population (p < 0.0001). A significant telomere shortening parallels this finding in the post-COVID-19 cohort compared with COVID-19-free subjects (p < 0.0001). Additionally, ACE2 expression was decreased in post-COVID-19 patients, compared with the COVID-19-free population, while DPP-4 did not change. In light of these observations, we hypothesize that some epigenetic alterations are associated with the post-COVID-19 condition, particularly in younger patients (< 60 years).
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Affiliation(s)
- Alessia Mongelli
- Laboratory of Epigenetics, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 10, 27100 Pavia, Italy; (A.M.); (V.B.); (M.G.Z.); (S.A.); (L.F.)
| | - Veronica Barbi
- Laboratory of Epigenetics, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 10, 27100 Pavia, Italy; (A.M.); (V.B.); (M.G.Z.); (S.A.); (L.F.)
| | - Michela Gottardi Zamperla
- Laboratory of Epigenetics, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 10, 27100 Pavia, Italy; (A.M.); (V.B.); (M.G.Z.); (S.A.); (L.F.)
| | - Sandra Atlante
- Laboratory of Epigenetics, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 10, 27100 Pavia, Italy; (A.M.); (V.B.); (M.G.Z.); (S.A.); (L.F.)
| | - Luana Forleo
- Laboratory of Epigenetics, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 10, 27100 Pavia, Italy; (A.M.); (V.B.); (M.G.Z.); (S.A.); (L.F.)
| | - Marialisa Nesta
- Foundation “Policlinico Universitario A. Gemelli IRCCS”, Department of Translational Medicine & Surgery, Faculty of Medicine, and Department of Cardiovascular Science, Catholic University of the Sacred Heart, 00168 Rome, Italy; (M.N.); (M.M.); (A.P.); (S.N.)
| | - Massimo Massetti
- Foundation “Policlinico Universitario A. Gemelli IRCCS”, Department of Translational Medicine & Surgery, Faculty of Medicine, and Department of Cardiovascular Science, Catholic University of the Sacred Heart, 00168 Rome, Italy; (M.N.); (M.M.); (A.P.); (S.N.)
| | - Alfredo Pontecorvi
- Foundation “Policlinico Universitario A. Gemelli IRCCS”, Department of Translational Medicine & Surgery, Faculty of Medicine, and Department of Cardiovascular Science, Catholic University of the Sacred Heart, 00168 Rome, Italy; (M.N.); (M.M.); (A.P.); (S.N.)
| | - Simona Nanni
- Foundation “Policlinico Universitario A. Gemelli IRCCS”, Department of Translational Medicine & Surgery, Faculty of Medicine, and Department of Cardiovascular Science, Catholic University of the Sacred Heart, 00168 Rome, Italy; (M.N.); (M.M.); (A.P.); (S.N.)
| | - Antonella Farsetti
- Institute for Systems Analysis and Computer Science “A. Ruberti” (IASI), National Research Council (CNR), 00185 Rome, Italy;
| | - Oronzo Catalano
- Cardiac Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 10, 27100 Pavia, Italy;
| | - Maurizio Bussotti
- Cardiorespiratory Rehabilitation Department, IRCCS Maugeri Clinical Scientific Institutes, 20097 Milan, Italy; (M.B.); (L.A.D.V.)
| | - Laura Adelaide Dalla Vecchia
- Cardiorespiratory Rehabilitation Department, IRCCS Maugeri Clinical Scientific Institutes, 20097 Milan, Italy; (M.B.); (L.A.D.V.)
| | - Tiziana Bachetti
- Scientific Direction, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 4, 27100 Pavia, Italy; (T.B.); (M.T.L.R.)
| | - Fabio Martelli
- Laboratory of Molecular Cardiology, Policlinico San Donato IRCCS, San Donato Milanese, 20097 Milan, Italy;
| | - Maria Teresa La Rovere
- Scientific Direction, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 4, 27100 Pavia, Italy; (T.B.); (M.T.L.R.)
- Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Carlo Gaetano
- Laboratory of Epigenetics, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 10, 27100 Pavia, Italy; (A.M.); (V.B.); (M.G.Z.); (S.A.); (L.F.)
- Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
- Correspondence: ; Tel.: +39-038-259-2262
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17
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Rowbotham MC, Arendt-Nielsen L. A year like no other: introduction to a special issue on COVID-19 and pain. Pain Rep 2021; 6:e915. [PMID: 33997584 PMCID: PMC8116039 DOI: 10.1097/pr9.0000000000000915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 02/12/2021] [Indexed: 12/23/2022] Open
Affiliation(s)
- Michael C. Rowbotham
- Pain Management Center, University of California School of Medicine, San Francisco, CA, USA
- Treasurer, International Association for the Study of Pain (IASP), Washington, DC, USA
| | - Lars Arendt-Nielsen
- Center for Neuroplasticity and Pain (CNAP), School of Medicine, Aalborg University, Aalborg, Denmark
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18
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Asadi-Pooya AA, Nemati H, Shahisavandi M, Akbari A, Emami A, Lotfi M, Rostamihosseinkhani M, Barzegar Z, Kabiri M, Zeraatpisheh Z, Farjoud-Kouhanjani M, Jafari A, Sasannia F, Ashrafi S, Nazeri M, Nasiri S. Long COVID in children and adolescents. World J Pediatr 2021; 17:495-499. [PMID: 34478045 PMCID: PMC8414448 DOI: 10.1007/s12519-021-00457-6] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/22/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND To identify the prevalence and also the full spectrum of symptoms/complaints of children and adolescents who are suffering from long COVID. Furthermore, we investigated the risk factors of long COVID in children and adolescents. METHODS All consecutive children and adolescents who were referred to the hospitals anywhere in Fars province, Iran, from 19 February 2020 until 20 November 2020 were included. All patients had a confirmed diagnosis of COVID-19. In a phone call to patients/parents, at least 3 months after their discharge from the hospital, we obtained their current status and information if their parents agreed to participate. RESULTS In total, 58 children and adolescents fulfilled the inclusion criteria. Twenty-six (44·8%) children/adolescents reported symptoms/complaints of long COVID. These symptoms included fatigue in 12 (21%), shortness of breath in 7 (12%), exercise intolerance in 7 (12%), weakness in 6 (10%), and walking intolerance in 5 (9%) individuals. Older age, muscle pain on admission, and intensive care unit admission were significantly associated with long COVID. CONCLUSIONS Long COVID is a frequent condition in children and adolescents. The scientific community should investigate and explore the pathophysiology of long COVID to ensure that these patients receive appropriate treatments for their condition.
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Affiliation(s)
- Ali A. Asadi-Pooya
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ,grid.265008.90000 0001 2166 5843Department of Neurology, Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, PA USA
| | - Hamid Nemati
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mina Shahisavandi
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Akbari
- grid.412571.40000 0000 8819 4698Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Emami
- grid.412571.40000 0000 8819 4698Burn & Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrzad Lotfi
- grid.412571.40000 0000 8819 4698Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahtab Rostamihosseinkhani
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohreh Barzegar
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Kabiri
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Zeraatpisheh
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Farjoud-Kouhanjani
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anahita Jafari
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fateme Sasannia
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shayan Ashrafi
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoume Nazeri
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Nasiri
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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